People close to McCain say that his condition has deteriorated, and he likely doesn’t have much time left. It’s a grueling decision for anyone to make, to discontinue treatment for something as serious as cancer.

My thoughts go out to the Senator and his family.

1. What is brain cancer? What type does Senator McCain have?

Brain cancer is what happens when a malignant tumor grows inside the cells of the brain. Not all brain tumors are malignant, or cancerous. Unfortunately, the tumor that Senator McCain has IS, and it’s one of the worst kinds. It’s called a glioblastoma. These cancer cells develop within the brain and grow very quickly because they’re supplied with lots of blood. Nearly 40 percent of people who develop glioblastoma die within a year.

2. What treatment has the Senator had?

Last summer, McCain had surgery above his eye for a blood clot that turned out to be associated with glioblastoma. When it was determined that he had this aggressive form of cancer, he began chemotherapy and radiation treatments. The chemo drugs and radiation energy kill cancer cells. But glioblastomas are notoriously difficult to kill with these treatments, due to the speed and efficiency with which they spread throughout the brain.

3. In your practice, how do your help and counsel patients in their decision to discontinue care?

I honor the requests of the family. In all of the treatments that I offer it’s always a matter of risk versus benefit. If the treatment is beneficial, then we should continue. However, if the family and I agree that the treatment is NOT beneficial, or is causing more discomfort or harm to the patient, it may be worthwhile to consider discontinuing the treatment. In that case, I’ll make referrals to hospice care if necessary.

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